Poll Worker Application Form

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If you are interested in becoming a Poll Worker in Nash County, please complete the form below. You must be a registered voter in Nash County to serve as a poll worker in Nash County. If you reside in another county please contact your county's Board of Elections Office. Thank you for your interest!

First Name*

Last Name*

Street Address*

Mailing Address (If different):

City*

State*

Zip*

Main Phone Number*

Secondary Phone Number

Email Address*

Re-Enter Email Address*

Date of Birth*

Date of Birth

Party Affiliation*

Choose which describes your computer knowledge and experience.*

How did you learn about becoming a Poll Worker*

Have you worked as a Poll Worker before?*

Yes

No

If so, where?

Tell us a little about why you are interested in working as a Poll Worker.

Note: Completing this form is a request only and does not guarantee you will be selected to serve as a poll worker.